The physician-patient relationship is substantially influenced by issues involving ethics, morality, law, and politics. Throughout this article, the nexus between law and medicine will be emphasized. Perhaps the most important of these associations is the relationship between principles, duties and rights. Justice Holmes aptly stated that since no rights were absolute, they were poor tools for analysis in any case because they were not truly fundamental considerations. "Duties precede rights logically and chronologically." Holmes eventually came to view "duties" as derivative notions and thought that it was essential to understand the principles at work, not the moral sounding labels attached to the results. Consistent with this reasoning, this article will explore the nature of the ethical and legal foundations of the physician-patient relationship and its most important principle, the doctrine of informed consent. In addition, it will review the constitutional legitimacy of the relationship, the duties imposed upon it, which rights, if any, flow to the mother and the fetus, and how these principles interact with the physician's role in so-called maternal-fetal conflicts. The ultimate question is whether the state can formulate a compelling interest in overruling the autonomy of the individual patient, in this case, a pregnant woman. The entire area of reproductive technology, prenatal care, and the approach to the fetus is affected by this issue, and this analysis should provide a clearer understanding of the physician's medical and legal role in such controversies.
James J. Nocon, Physicians and Maternal-Fetal Conflicts: Duties, Rights and Responsibilities, 5 J.L. & Health 1 (1990-1991)